The disruption of sleep causes excessive sleepiness during the working hours. Sleep research in the past few years suggest that snoring even without sleep apnea syndrome may also disturb sleep significantly. Sleepiness is a global epidemic. Fatigue accounts for about 40 percent of commercial trucking accidents, which causes 4,000 deaths and 12,000 injuries per year. It also causes a breakdown in marital and family ties. The true nature of the challenge, i.e., to identify and treat the millions of people who have sleep apnea syndrome, is truly staggering. Patients with sleep apnea syndrome are in danger of harming themselves and may be at risk to others.
The present invention has been developed to aid in the elimination of snoring and the various degrees of hypopnea and apnea that occur due to pathological disturbances in the sleep process. One of the main reasons of the sleep disturbance is the relaxation of the tongue to varying degrees during the several stages of sleep. When fully awake, the tongue has normal tone as air normally passes in and out of the lungs during respiration. However, during sleep, the tongue is lax. As air is drawn into the lungs by the muscles of respiration, the tongue is drawn back against the posterior wall of the pharynx in a fluttering fashion. As the posterior part of the tongue hits the posterior wall of the pharynx with rapidity, the to and fro action of the tongue causes loud and disturbing snoring sounds. When sleeping in a supine position, the effect of gravity makes the snoring worse.
The more serious type of sleep disturbance is obstructive sleep apnea, which occurs when the tongue goes against the posterior wall of the pharynx preventing any air from entering the lungs. The effort of the muscles of respiration causes the blockage to seal even tighter. The apnea causes a drop in the blood oxygenation and increases the blood carbon dioxide level. The heart is affected adversely with the blood pressure and pulse rate increasing. Sometimes arrhythmias may occur. The brain is affected by the carbon dioxide buildup causing the person to be aroused. On awakening there is a return to tonicity of the muscles of the tongue, which allow normal breathing to resume. After some time the person goes back to sleep and the process occurs all over again.
The American Sleep Apnea Association rates obstructive sleep apnea events per hour as the Respiratory Distress Index (RDI). It rates 0-5 RDI""s as normal, 5-20 as mild, 20-40 as moderate, and over 40 as severe. In a few cases RDI""s were above 100; with events lasting 90 to 120 seconds with oxygen saturation going below 70% when normal is 95% to 100%. All aspects of quality of life, from physical and emotional health, to social functioning are impaired by the obstructive sleep apnea.
Much research has been done worldwide on correcting sleep disorders. The most prominent treatment used presently is the Mask and Nasal Continuous Positive Airway Pressure (CPAP). The nasal C-PAP is more accepted than the mask but compliance is poor. Frequent side affects occur such as dryness, mucous congestion, sinusitis, rhino rhea, sneezing, and mucous in the throat. Breathing out against positive air pressure is also discomforting. Other treatments include a tongue retaining device (TRD) made of soft plastic that have a tongue shaped cavity that is supposed to hold the tongue in a forward position after a suction is formed within the mouth by the user. The negative pressure created within the mouth draws the tongue forward into the tongue cavity. With this method, adequate suction is not developed and not maintained for long. Another device clamps the tongue and holds it in a forward position. Some units were uncomfortable to wear. In some experiments, it was worn only half of the night. Despite drawbacks, the TRD was found to decrease the number of apnea events by approximately 50%. Thus far, TRD has not excited a lot of enthusiasm in the research community. The Samelson device (U.S. Pat. No. 4,304,227) holds the tongue forward within a cavity with suction created by the tongue forcing its way into the cavity. However, this suction force does not last for a prolonged period of time. The Samelson device also does not allow any mouth breathing and is not successful if there is any type of obstruction in the nasal passages. Dental devices have been devised to advance the mandible, such as disclosed in U.S. Pat. No. 4,715,368 which enhances the space between the posterior tongue surface and the posterior pharyngeal wall. However, problems arise because of dislocation of the temperomandibular joint causing pain in the joints and sometimes in the teeth. Occasionally a permanent mal occlusion develops.
The present invention differs from the Samelson device by creating a suction with an external source and permitting the user to breathe through the mouth. This is important because even when there is normal nasal anatomy, the nasal passages may become congested, especially when infection or allergies are present.
The embodiment of my invention is a one-piece oral device for treatment of obstructive sleep disorders. The invention includes a mouthpiece portion that fits within the anterior part of the oral cavity of a person much like the mouthpieces used in snorkel and scuba devices when swimming. The anterior or forward part of the invention protrudes outwardly through the lips as illustrated in FIG. 1 and includes a tongue shaped cavity for receiving the tongue. A small channel communicates with the tongue shaped cavity and is connected via a length of tubing to an outside source of low suction pressure. There is no difficulty in swallowing saliva with the tongue being in the forward position throughout the night since the tongue is held forward.
It is one object of the present invention to provide a method and apparatus for reducing or eliminating snoring, hypopnea, or apnea by holding the tongue in a forward position in such a way that no portion of the tongue or other oral soft tissue will vibrate during breathing.
It is a further object of the present invention to provide a method and apparatus for reducing or eliminating snoring, hypopnea, or apnea by not only holding the tongue in a forward position but also permit oral breathing through the mouth particularly should nasal congestion occur.
It is a further object of the present invention to provide a device for reducing or eliminating snoring, hypopnea or apnea which is comfortable to use and easy to manufacture.
These and other objects and advantages of the present invention will become clear from the following description of a preferred embodiment of the invention.